Post-Surgery Concerns: Green Discharge After Fistula Surgery - Surgery

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Postoperative care after fistula surgery?


Hello Doctor: I underwent fistula surgery on April 14, and it has now been 10 days.
Over the past couple of days, after each sitz bath, I have noticed that the drainage is a greenish pus-like substance.
On regular days, the drainage on the gauze is a light red and white pus-like fluid, but lately, after the warm sitz baths, I consistently notice this greenish discharge.
The doctor mentioned that this is normal secretion!? Currently, there is no severe pain, fever, or redness around the wound.
I am wondering if you have encountered a situation like mine before?

Xiao Bai, 40~49 year old female. Ask Date: 2023/04/24

Dr. Ke Fangxu reply Surgery


It is normal to have discharge from the wound after fistula surgery.
However, green discharge is somewhat concerning.
If there is no redness, swelling, heat, or pain, it can be monitored, as the anal area is not a sterile environment and mild bacterial growth is not unusual.
If the color is not very dark and this phenomenon only occurs during the first sitz bath in the morning, it should not be a cause for concern.
Otherwise, it is advisable to consult a physician to determine if antibiotic treatment is necessary.

Reply Date: 2023/04/24

More Info


After undergoing fistula surgery, it's not uncommon to experience various types of discharge as part of the healing process. In your case, the presence of green discharge can be concerning, but it’s important to consider a few factors to determine whether this is a normal part of recovery or a sign of potential complications.

Firstly, the color and consistency of the discharge can provide insights into the healing process. A green discharge often indicates the presence of pus, which can be a sign of infection. However, it’s also possible for the body to produce different types of discharge as it heals. The fact that you mentioned the discharge was previously a combination of light red and white, which is more typical of serous or sanguineous fluid, suggests that your body is responding to the surgical site in a dynamic way.

The absence of severe pain, fever, or significant redness and swelling at the surgical site is a positive sign. These symptoms are often associated with infections and their presence would warrant immediate medical attention. Since you are not experiencing these symptoms, it may indicate that your body is managing the healing process adequately, despite the change in discharge color.

However, it’s crucial to monitor the situation closely. If the green discharge persists or worsens, or if you begin to experience any new symptoms such as increased pain, fever, or swelling, it would be advisable to contact your healthcare provider. They may want to assess the surgical site to rule out any potential infection or complications.
In terms of post-operative care, continue to follow your doctor's recommendations regarding wound care. This typically includes keeping the area clean and dry, performing sitz baths as recommended, and changing dressings as needed. If your doctor has advised that the green discharge is a normal part of healing, ensure you maintain good hygiene to prevent any secondary infections.

Additionally, it’s important to stay hydrated and maintain a balanced diet to support your body’s healing process. Adequate nutrition can help bolster your immune system, which is vital during recovery. If you have any concerns about your diet or hydration, consider discussing this with your healthcare provider or a nutritionist.

In summary, while the presence of green discharge after fistula surgery can be concerning, it may not necessarily indicate a serious problem, especially in the absence of other alarming symptoms. However, vigilance is key. Keep an eye on your symptoms, maintain proper wound care, and don’t hesitate to reach out to your healthcare provider if you have any concerns or if your symptoms change. Your health and peace of mind are paramount during your recovery process.

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